Impact of surgical site infections after open and laparoscopic colon and rectal surgeries on postoperative resource consumption

Fukuda, Haruhisa; Morikane, Keita; Kuroki, Masahide; Kawai, Shinya; Hayashi, Kouji; Ieiri, Yuko; Matsukawa, Hiroshi; Okada, K.; Sakamoto, Fumie; Shinzato, Takashi; Taniguchi, Shinichiro

doi:10.1007/s15010-012-0317-7

Cited by 30 publications

(34 citation statements)

References 18 publications

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“…A study from a single hospital in the UK found that the additional costs for patients who developed a SSI were £5239 (€5846) higher. Another study compared the costs of patients with, and without SSI between eight different hospitals in Japan and found the additional costs ranged from US $853 to US $5348 (€785–4925), with great variation between hospitals.…”

Section: Introductionmentioning

confidence: 99%

Alternatives to antibiotics for prevention of surgical infection

Ploegmakers

Damink

Breukink

2017

British Journal of Surgery

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Background: Surgical-site infection (SSI) is still the second most common healthcare-associated infection, after respiratory tract infection. SSIs are associated with higher morbidity and mortality rates, and result in enormous healthcare costs. In the past decade, several guidelines have been developed that aim to reduce the incidence of SSI. Unfortunately, there is no consensus amongst the guidelines, and some are already outdated. This review discusses the recent literature regarding alternatives to antibiotics for prevention of SSI.Methods: A literature search of PubMed/MEDLINE was performed to retrieve data on the prevention of SSI. The focus was on literature published in the past decade.

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Section: Introductionmentioning

confidence: 99%

Alternatives to antibiotics for prevention of surgical infection

Ploegmakers

Damink

Breukink

2017

British Journal of Surgery

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“…Once it occurred, patients would suffering from pain, cost of treatments [3, 4], prolonged length of hospital stay, and intangible loss [5]. …”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis of randomised controlled trials of delayed primary wound closure in contaminated abdominal wounds

et al. 2014

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A systematic review and meta-analysis was conducted to compare surgical site infection (SSI) between delayed primary (DPC) and primary wound closure (PC) in complicated appendicitis and other contaminated abdominal wounds. Medline and Scopus were searched from their beginning to November 2013 to identify randomised controlled trials (RCTs) comparing SSI and length of stay between DPC and PC. Studies’ selection, data extraction, and risk of bias assessment were done by two independent authors. The risk ratio and unstandardised mean difference were pooled for SSI and length of stay, respectively. Among 8 eligible studies, 5 studies were done in complicated appendicitis, 2 with mixed complicated appendicitis and other types of abdominal operation and 1 with ileostomy closure. Most studies (75%) had high risk of bias in sequence generation and allocation concealment. Among 6 RCTs of complicated appendicitis underwent open appendectomy, the SSI between PC and DPC were not significantly different with a risk ratio of 0.89 (95% CI: 0.46, 1.73). DPC had a significantly 1.6 days (95% CI: 1.41, 1.79) longer length of stay than PC. Our evidence suggested there might be no advantage of DPC over PC in reducing SSI in complicated appendicitis. However, this was based on a small number of studies with low quality. A large scale RCT is further required.

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“…Prevention of surgical site infections is an important step to reduce rates of morbidity and mortality and costs. [14][15][16] Several systematic reviews have shown that ERAS and SSIB pathways can decrease length of stay and rates of perioperative morbidity and surgical site infection. [3][4][5]7,10 To our knowledge, only 1 study has presented the combined effects of both evidence-based pathways in a single institution, 3 and only 2 studies evaluating standardized care pathways have been conducted in smaller community centres.…”

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confidence: 99%

Impact of sequential implementation of multimodal perioperative care pathways on colorectal surgical outcomes

D’Souza

Choi

Wootton

et al. 2019

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Background: Standardized care protocols offer the potential to reduce postoperative complication rates. The purpose of this study was to determine whether there was an additive benefit associated with the sequential implementation of the evidence-based surgical site infection bundle (SSIB) and enhanced recovery after surgery (ERAS) protocols for patients undergoing colorectal surgery in a community hospital. Methods: Patients at a single institution who underwent elective colorectal surgery between Apr. 1, 2011, and Dec. 31, 2015, were identified by means of American College of Surgeons National Surgical Quality Improvement Program data. Patients were stratified into 3 groups according to the protocol implementation dates: pre-SSIB/pre-ERAS (control), post-SSIB/pre-ERAS and post-SSIB/post-ERAS. Primary outcomes assessed were length of stay and wound complication rates. We used inverse proportional weighting to control for possible differences between the groups. Results: There were 368 patients included: 94 in the control group, 95 in the post-SSIB/pre-ERAS group and 179 in the post-SSIB/post-ERAS group. In the adjusted analyses, mean length of stay (control group 7.6 d, post-SSIB/post-ERAS group 5.5 d, p = 0.04) and overall wound complication rates (14.7% and 6.5%, respectively, p = 0.049) were reduced after sequential implementation of the protocols. Conclusion: Sequential implementation of quality-improvement initiatives yielded additive benefit for patients undergoing colorectal surgery in a community hospital, with a decrease in length of stay and wound complication rates. The amount of improvement attributable to either initiative is difficult to define as they were implemented sequentially. The improved outcomes were realized after the introduction of the ERAS protocol in adjusted analyses. Contexte : Les protocoles de soins standardisés offrent la possibilité de réduire les taux de complications postopératoires. Le but de cette étude était de déterminer s'il y a un avantage additif associé à l'application séquentielle des protocoles fondés sur des données probantes SSIB (surgical site infection bundle) et ERAS (enhanced recovery after surgery) chez des patients soumis à une chirurgie colorectale dans un hôpital communautaire. Méthodes : Les patients d'un seul établissement ayant subi une chirurgie colorectale non urgente entre le 1 er avril 2011 et le 31 décembre 2015 ont été recensés à partir des données du Programme national d'amélioration de la qualité chirurgicale de l'American College of Surgeons. Les patients ont été stratifiés en 3 groupes selon les dates d'application des protocoles : pré-SSIB/pré-ERAS (témoin), post-SSIB/pré-ERAS et post-SSIB/post-ERAS. Les paramètres principaux évalués étaient la durée du séjour hospitalier et les taux de complications de plaies. Nous avons utilisé une pondération proportionnelle inverse pour tenir compte des possibles différences entre les groupes. Résultats : Nous avons inclus 368 patients, 94 dans le groupe témoin, 95 dans le groupe post-SSIB/pré-ERAS et 179 ...

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Impact of surgical site infections after open and laparoscopic colon and rectal surgeries on postoperative resource consumption

Abstract: This study quantified the impact of SSIs on resource consumption and confirmed significant cost variations among hospitals. These variations could not be explained by patient characteristics or infection type.

Cited by 30 publications

References 18 publications

Alternatives to antibiotics for prevention of surgical infection

Alternatives to antibiotics for prevention of surgical infection

A systematic review and meta-analysis of randomised controlled trials of delayed primary wound closure in contaminated abdominal wounds

Impact of sequential implementation of multimodal perioperative care pathways on colorectal surgical outcomes

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